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Overview of the strategy to control and prevent Cholera in West and Central Africa: The “Shield and Sword” concept

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The “shield and sword” concept, a common language for a proactive, cross-border and multi-disciplinary strategy to prevent the spread of cholera

An evidence-based and multi-sectorial approach targeting high-risk populations, locales, periods and practices

Intervention at a national, cross-border and regional level both before and during outbreaks as well as over the long-term

Building bridges between emergency response and development programs

Achieving national commitment from water, sanitation and hygiene (WASH) and health stakeholders to strongly engage in comprehensive strategies to eliminate cholera

Advocacy towards donors as well as WASH and health stakeholders for long-term intervention in cholera hotspots


a.History of cholera control

Since 2007, several epidemiological studies aiming to better understand cholera dynamics at a national, cross-border and regional level have been conducted in West and Central Africa.
The findings have established the foundation for a strategy to control and prevent cholera in this region of Africa.

Furthermore, between 2006 and 2012, the regional cholera strategy was built from lessons learned from pilot response projects implemented in Democratic Republic of Congo, Chad and Guinea. The approach was based on the integration of WASH (water, sanitation and hygiene), epidemiology and the use of GIS (geographical information systems) to target and optimize interventions. During the same period, regional and sub-regional workshops have taken place in the region to define the framework for a better collaboration between countries.

In 2012, due to the lack of cross-border collaboration and the delayed response during the cholera epidemic in Sierra Leone and Guinea, the West and Central Africa Cholera Platform was established. Since 2013, UNICEF has established partnership with ECHO through regional projects with the main objective of reducing the incidence of cholera via animation of the regional platform and promotion of an integrated and targeted approach known as the “shield and sword” strategy